The problem with compatibility is that if the two meds come directly in contact, precipitates can form (white snow-like particles) that can cause problems in the vasculature. It seems counterintuitive, but it REALLY is the very best place to infuse. Even with chemo drugs that are very caustic the VERY best place to infuse them is right above the heart itself, the blood flow is such that the heart is protected. I always had questions about medications that were hard on veins being injected directly into the heart through a central catheter.how was that a good idea? I always wondered. The tip of the triple lumen is in the superior vena cava and the blood flow there is so fast and turbulent and there is so much of it that compatibility at that point is NOT an issue. Thanks for your help.hopefully you'll let me know if I'm on the right track. My weakness is the hands on stuff, however, and since we only have 3 total check-offs in our entire BSN program I get super nervous, (yeah I think it should be more that that too)!!! I'd rather be taking boards on Friday!!!! Our instructors unfortunately are not perfect (nor available 24/7) and this was just a gray area for many students!!! I have maintained a 4.0 through the program and will hopefully, if I pass this check-off, graduate summa cum laude in December. Oh, and please do not assume I have not exhausted all of my resources. Does this sound right? I'm just nervous about the non-compatible meds mixing somewhere after they leave the catheters. If the ivpb med ordered is not compatible then I'd do the same thing. If it's an ivpb I'm thinking to not bother piggy backing it into the infusing fluids but to just set it up with primary tubing to the other non-blood port, flushing before and after it's done and then hep. to the other non-blood port (not distal). now I'm thinking that you would just swab, flush, push med, flush and hep. that you could just pinch the primary, swab, push med., then unpinch. I'm assuming if there is a primary infusing and your med is a push and is comp. Unfortunately we were taught this for only a short 5 minutes or so (for me almost 2 years ago) and our lab manuel doesn't go over it at all, except to say that agencies will differ on their protocols. I know the protocols will differ on amount to flush and amt and if to heparinize. meds in critical care and trauma and if they're administering TPN. I know that the meds won't mix in the lumen of the triple lumens, but will they mix when they enter the blood stream and then react? I did some more research on the web and it seem that the point of triple lumen is to be able to administer incomp. Now, for compatible IVPB, is there a need to flush? For a non-compatible IVPB, what is the other option (besides running it through the MIVF that you know is not compatible)? And think about this: what is the point of having more than oine lumen available? Think it through and you will do much better on your checkoff than if we were to sit here and give you instructions to memorize. For that, you'll need to go on whatever the instructor taught you. For example, where I work, we no longer flush anything with heparin (unless it is an IP that we are de-accessing). If the med you need to give (in any form) is not compatible with the MIV that is running, can you give them together through the same lumen? If it is compatible, no problemo, right?Īs far as flushing and things, that is based on hospital policy and you will need to look that up. You know that you have three different lumens available. That being said, I have no problem with a push in the right direction. I'm not trying to be mean, but how will you learn to do this stuff if you don't do the legwork now? Besides that, if we tell you what we do, and it is different from what your instructor taught you, will she be cool with "oh well that's what they said to do on allnurses"? I don't like doing other people's homework for them. First of all, if you have checkoffs on this, I think you should have the information available to you somewhere (books, notes, etc).
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